Provider Demographics
NPI:1649893793
Name:NOVA PRIMARY CARE LLC
Entity type:Organization
Organization Name:NOVA PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:AGGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-223-3833
Mailing Address - Street 1:1860 TOWN CENTER DR STE 340
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5912
Mailing Address - Country:US
Mailing Address - Phone:571-223-3833
Mailing Address - Fax:571-223-3834
Practice Address - Street 1:1860 TOWN CENTER DR STE 340
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5912
Practice Address - Country:US
Practice Address - Phone:571-223-3833
Practice Address - Fax:571-223-3834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-24
Last Update Date:2020-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty